“中途之家”新型社区服务模式在脊髓损伤患者康复中的应用

Application of ＂halfway house＂ model of community rehabilitation services in patients with spinal cord injury

目的 探讨脊髓损伤患者“中途之家”新型社区康复服务模式.方法 2011年菠萝岭社区卫生服务中心与南宁市、城区残联合作建立“中途之家”,采取专业指导和伤友互动相结合、集中训练和自主训练相结合、机构训练和社区活动相结合的康复服务模式对36例脊髓损伤患者进行干预.采用ASIA评分、改良Barthel指数（MBI）、功能综合评定量表（FCA）评定ADL能力,分别在康复服务干预前、康复服务干预3个月末进行评价.结果 干预3个月末36例患者ASIA评分中运动（49.97±12.17）分、触觉（61.38 ±11.68）分、感觉（57.91 ±12.69）分,改良Barthes指数评分（78.8±10.0）分,FCA量表评分（74.09±13.25）分,均高于干预前的（35.76±11.83）,（49.29±9.54）,（47.35±13.92）,（41.5±13.2）,（55.63 ±15.90）分,干预前后比较,差异有统计学意义（t值分别为5.024,4.810,3.364,13.514,5.352;P＜0.01）.结论 脊髓损伤患者在“中途之家”接受新型社区康复服务,可以有效改善肢体运动功能,提高日常生活活动能力,值得推广.

Objective To investigate the effect of ＂halfway house＂ model of community rehabilitation service on patients with spinal cord injury.Methods From 2011 year,＂halfway house＂ was established by the cooperation of community health service center,Nanning city,and district FIMITIC.We provided rehabilitation intervention for 36 cases with spinal cord injury,such as professional guidance,interactive combination between injured friends,intensive training and independent training,training institutions and community activities.ASIA,modified barthel index （MBI）,functional comprehensive assessment scale （FCA） were used to evaluated before the intervention and 3 month after rehabilitation intervention.Results ASIA score such as movement [（49.97 ± 12.17） vs （35.76 ± 11.83）],touch [（61.38 ± 11.68） vs （49.29 ± 9.54）],feeling [（57.91 ± 12.69） vs（47.35 ± 13.92）],MBI score [（78.8 ± 10.0） vs （41.5 ± 13.2）],FCA score [（74.09 ± 13.25） vs （55.63 ± 15.90）] were significantly higher after 3 month after rehabilitation intervention than before rehabilitation intervention,and the differences were statistically significant （t =5.024,4.810,3.364,13.514,5.352 ;P ＜ 0.01）.Conclusions Patients with spinal cord injury accept the new community rehabilitation service of ＂halfway house＂,can effectively improve their motor function,improve their ability of daily life,which worthy of promotion.